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November 2013
Humacyte: Investigational Bioengineered Blood Vessels For End-Stage Renal Disease

Sentara is one of only three sites in the United States to be a part of a trial for implanting investigational bioengineered vessels to speed blood flow for patients in dialysis treatment for end-stage renal disease.

Kidneys play a vital role in removing waste, salt and excess water from the body. For the over 26 million American adults who have Chronic Kidney disease (CKD) and an estimated millions of others who may be at risk for CKD*, the kidneys are no longer able to keep up with the body’s need for cleansing the blood. At that point the patient may require dialysis, an artificial method to do the kidneys’ job to clean our blood.

While dialysis can be lifesaving, it does require a healthy blood vessel in the arm, chest or an alternative “port” for the dialysis procedure to cleanse the blood. For some patients with end-stage renal disease in prolonged dialysis treatments, the natural vessel may become weakened and the blood cleansing flow slows or is obstructed. If a surgeon is unable to identify a viable blood vessel, a graft from another part of the patient’s blood vessel system or a synthetic graft may be implanted to connect an artery with a vein to allow dialysis to continue.

The technique of using a flexible, synthetic (plastic) tubing to graft together an artery and a vein to create a new “vessel” and to increase blood flow during dialysis is not new. However, with this clinical trial, the make-up of the “vessel” and the placement are what is different.

The Humacyte** graft is the first investigational bioengineered blood vessel transplant to be performed for patients in the US. Made of human collagen and decellularized (basically washing away the cells and cell contents), these bioengineered grafts are being studied to test the potential to lower the risk of rejection by the body and reduce scarring, thickening and rejection that can sometimes occur with synthetic vessels.

This U.S. clinical trial will assess the safety and performance of these investigational bioengineered blood vessels when implanted into the arms of dialysis patients who would otherwise have a synthetic plastic graft connecting an artery to a vein to speed up their blood flow during dialysis treatments.

- People with diabetes and high blood pressure represent two-thirds of the cases of Chronic Kidney Disease.*

- The investigational bioengineered blood vessels are made with biological proteins similar to the body’s own blood vessels and can be stored for months until needed.

 * National Kidney Foundation, http://www.kidney.org/kidneydisease/aboutckd.cfm
** For more information on Humacyte, visit http://www.Humacyte.com

October 2013
3-Dimensional Mammography
(Tomosynthesis)

The Sentara Cancer Network is the first in the Hampton Roads area to introduce 3D mammography, the latest clinical innovation for breast imaging. By the end of this year, eight locations, including all of the Sentara Comprehensive Breast Centers, will be offering this
FDA-approved technology.

It’s fairly well-known that mammography is the gold standard in screening for the early detection of breast cancer. Several years ago, the introduction of digital mammography offered sharper, computerized breast images that were more easily available for comparisons with previous mammograms. Now, tomosynthesis, the medical name for a 3D mammogram, takes mammography to a whole new dimension.

A 3D mammogram starts out the same as a regular, 2-dimensional mammogram. The woman’s breast is positioned and held in place for the mammogram machine to capture multiple views. Once this 2-dimensional mammogram is complete, a specialized attachment to the mammogram machine that is powered by sophisticated compu-terized software is able to gather 3-dimensional views from quick arc-like movements around the breast. The 3D pictures collected from the circular views provide the radiologist with a closer look at any potential areas of concern.

Digital mammography remains the gold standard for early detection of breast cancer. The Sentara Cancer Network is enhancing its ability to find breast cancer earlier by providing this new option to women in Hampton Roads. There is a charge for the 3D portion of the mammogram.

For a 3D mammography location near you, visit www.sentara.com/3Dmammogram or call 1-800-SENTARA (1-800-736-8272).

The benefits of a 3D mammogram offer more good news for women: 
-  Fewer callbacks. In a recent study, there was a 38% drop in the need for a woman to be called back for another mammogram due to inconclusive or suspicious findings.* 
-  An impressive 35% more cancers are found at an earlier stage.*

* Source: American Journal of Roentgenology (AJR), June 2013

  

August 2013
Boosting the Immune System Against Kidney and Melanoma Cancers That Have Spread InterLeukin-2 (IL-2) Immunotherapy

The Sentara Cancer Network at Sentara CarePlex Hospital offers the only program in the eastern Virginia region to offer high dose InterLeukin-2 (IL-2) immunotherapy to treat metastatic melanoma or metastatic kidney cancer.

The human body’s immune system has special defense cells that can sometimes help destroy cancer cells. However, when the immune system is unable to keep cancer cells from increasing and spreading, metastatic disease develops. Special treatments called immunotherapy can give the immune system more power to fight back. With advances in immunotherapy, patients with metastatic melanoma or kidney cancer now have hope for longer term cancer control. InterLeukin-2 (IL-2) is an FDA-approved immunotherapy whose studies have demonstrated the potential for a complete and long-lasting response in these diseases.*

After this first course of treatment, the patient will typically receive imaging to determine if
the cancer responded to the treatment. If the medical oncologist sees a positive response,
a second course of treatment may be given. IL-2 shrinks tumors in about 15% of patients; about 5% of patients get a complete response that can last seven years or more.*

Patients receiving IL-2 treatments are under the care of medical oncologists and a highly skilled interdisciplinary team of caregivers who are trained in the care of patients with metastatic melanoma or metastatic kidney cancer. As with most cancer treatments, patients must be evaluated to determine if they are healthy enough to receive IL-2 and the common side effects that may accompany treatment.

* Source: Jarkowski, Wong. Journal of Clinical Medicine: Therapeutics, August 2009

July 2013

Investigational “Dissolving” Device for Treating Blockages in Heart Vessels Absorb III Study
Sentara Cardiovascular Research Institute is now enrolling patients in a national research study to test a dissolving heart device designed to open heart vessel blockages in patients with coronary heart disease.

Each year, about 785,000 Americans have a first heart attack. Another 470,000 who have already experienced one or more heart attacks will have another. With one of every six deaths in the U.S. due to heart disease,1 it’s vital to recognize blocked heart arteries and to restore blood flow to the heart. This narrowing of vessels in the heart due to a buildup of plaque is known as coronary artery disease and is the leading cause of death in men and women in the U.S. Sentara Cardiovascular Research Institute is now enrolling heart patients in a randomized multi-center clinical research trial to study an investigational “dissolving” device to treat blockages in the vessels serving the heart.

The study device, Absorb™ is produced by healthcare company Abbott. It is made of anaturally dissolvable material commonly used in dissolvable sutures. After Absorb dissolves, only two tiny pairs of markers remain in the artery to allow a physician to see where the device was placed.

Sentara Heart cardiologists at Sentara Heart Hospital in Norfolk have opened the Absorb III study to patients to test the safety  and effectiveness of this investigational bioresorbable device compared with current standard treatment of medicated metallic heart stents called drug eluting stents. Patients will be randomized to either receive the study device or have the standard treatment. The results of the two groups will be compared. To learn more about Sentara Cardiovascular Research Institute, visit www.sentara.com/heart. For more about the study and eligibility, call 757-388-5480 or visit www.clinicaltrials.gov.

May 2013

TheraSphere®
Selective Internal Radiation Therapy For Liver Cancer
Several dedicated professional teams worked closely together to bring the innovative TheraSphere® liver cancer treatment to the Sentara Cancer Network at Sentara Norfolk General Hospital. TheraSphere®, or selective internal radiation therapy, is good news for people with primary liver cancers that are not able to be surgically removed.

TheraSphere® treatment consists of millions of tiny glass beads, one third of the width of a human hair. The TheraSphere® glass beads contain radioactive yttrium-90 and are delivered directly to the liver tumor where they are most effective. TheraSphere® treatment is typically an outpatient procedure that does not require hospitalization. It is well tolerated by patients, with side-effects that are normally milder than with many other liver cancer treatments. Because the procedure is directed to the liver tumor, there is minimal impact to non-targeted tissue. After treatment, most TheraSphere® patients are eligible for further therapeutic options because the procedure does not block the vessels of the liver.

Benefits of TheraSphere®: 
- Outpatient procedure 
- Side effects can be milder than other liver cancer treatments 
- Targeted treatment offers minimal impact on surrounding tissue 
- Does not block vessels to the liver, leaving the option for further therapeutic treatments if needed

To find out if you are a candidate for this treatment, call 888-220-2214.

April 2013

Hands Down: Biometric Technology Improves Security Of Patient Identification
Sentara is the first to introduce a fast, accurate method of patient identification throughout Hampton Roads that uses harmless, near-infrared light to scan veins in your palm that uniquely identify you and connect you to your medical record.

The next time you step up to register for care at a Sentara facility, you might first be asked to scan your palm instead of your identification card. Providing safe care starts wth accurate identification. The innovatively designed Sentara Patient Idenfication System does just that - accurately identifies you.

By simply placeing your palm over the scanner, the infrared light waves recreate your palm vein pattern that is unique to you - even if you're an identical twin! This encrypted digital file is then electronically linked to your patient identification. So the next time you need care, identifying who you are can be as simple as scanning your palm.

Palm scans are secure to Sentara, and are only used to identify patients during the registration process, and not shared. Although it does add extra security and safety, patients are not required to be palm scanned to receive care and may choose to use traditional methods of identification.

January 2013

A Less Invasive Technique for Removing the Thymus

What is a Thymus?
 A specialized organ that regulates the immune system. 
 Located in front of the heart. 
 Largest size and most active in young children. 
 During the teen years, it shrinks up with minimal function in adults.

Thoracic and cardiothoracic surgeons at Sentara Norfolk General Hospital are the first in our area to be offering a less invasive technique for removing the thymus. It’s reducing the patient’s hospital stay and post-surgery pain.

The thymus has a very specialized job: make immune cells then, well, basically self-destruct. As crazy as that sounds, that’s exactly what happens with this immune system organ. From birth through early puberty, the thymus generates immune cells (“T-cells”) that attack different foreign substances in the body. Normally by adolescence, the raging hormones actually begin to shrink this organ, turning it into fatty tissue. But when cancerous tumors develop or symptoms of an auto-immune disorder Myasthenia Gravis develop, the thymus has to be surgically removed (thymectomy).

The traditional (trans-sternal) surgical approach of surgically removing the thymus begins with a long, vertical surgical incision through the breastbone that opens up the chest. This is the same approach used for some open-heart surgeries.

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